Work Requirements and Health: Projected Mortality Impacts of Medicaid Coverage Loss

Recent legislative proposals to impose nationwide work requirements for Medicaid eligibility could jeopardize health insurance coverage for over 36 million low-income Americans. To assess the potential mortality impact, we estimated annual excess deaths under a comprehensive set of scenarios reflecting varying policy implementations. These scenarios accounted for differences in age groups (19–55 vs. 19–64), eligibility based on Medicaid expansion status, and varying levels of automatic exemptions and reporting compliance. In the most optimistic scenarios—where work requirements are applied only to Medicaid expansion enrollees—we project 4,936 and 10,851 excess deaths annually among individuals aged 19–55 and 19–64, respectively. Under the most regressive scenario, where work requirements are imposed on all non-disabled Medicaid enrollees aged 19–64, the estimated annual excess deaths rise sharply to 53,144. These projections underscore the grave public health consequences of implementing Medicaid work requirements and highlight the need for careful evidence-based policymaking.